HANAMAN0
02 - - - �_ /CITY OF'LA QUINT
HOME OCCUPATION PERMIT
APPLICATION
P.O.78-105
Box I1504.
. o.l.�e,cx. •::aa
664-2246 PLANNING DIVISION 6187
lead each condition listed on the reverside side of this form to see
the proposed activity can comply with the City's Home Occupation
RECEIVEdegulations. $35.00 fee
Rogl/)1,2',?_'s A/0C/SE
-- - -
OCT;) fi 1990
APPLICANT' S NAME :-'/Js4W P,4A4 tiJ A-AJPHONE 617- S-6
CITY OF LA QUIN ;QTY owNE u /3 U•S--/ •4n/.¢.� i ,� PHONE
OEPi ERW ADDRESS / 5� 7
PLANNING & DEVELOPMENT (Street.)-
(city)
Street.)-(City) (State) (Zip)
Type of residence (Single, Multiple, mobile home, etc.) 57/AAG /-E
Type of business 51- "iot//sgT Ile ES
Brief description of how the business will operate 42g55c�-+,M3L/n/r
Number of persons involved in business oZi
• List names of persons employed ��4�ia /LiL����+�J//
Square footage of usable floor area in
house (exclude garage) / /9FO Validation Stamp
Location and square footage of area of 00518l 10 7903 10-30-90 i0
business activity in home (example: 10 CASH i TOTAL 1 35,00
bedrooms; 125 square feet)
Description of machinery, equipment, and supplies being used in the
business operation (9-•&41Ey
.I have read and understand and agree with the conditions by which a
home occupation is allowed (Conditions on reverse side).
APPLICANT SIGNATURE DATE
"If Applicant is other than property owner, authorization of owner or agent
required.
OtdNER OR AGENT SIGNATURE DATE
IMPORTANT: False or misleading information shall be grounds for denying
your Home Occupation, or failure to comply with conditions listed on
reverse shall be grounds for revocation of permit.
• f • f • • • ! R p• R • •
APPROVED S Initials �`-�- % O Date
CONDITIONS ATTACHED 4
�.� DENIED S Initials ,;, ) I- )3 -!3P_ Date
LQHOMOCC.PRT